<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304314294
Report Date: 05/17/2024
Date Signed: 06/14/2024 10:52:18 AM

Document Has Been Signed on 06/14/2024 10:52 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:GUERRERO, LUCYFACILITY NUMBER:
304314294
ADMINISTRATOR/
DIRECTOR:		G. NUBIA & G. LUCYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 822-5131
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/17/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Applicant, Lucy GuerreroTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 5/17/24, Licensing Program Analyst (LPA) Sun conducted a visit to follow up on the pre-licensing visit completed on 5/2/24. LPA met with Applicant, Lucy Guerrero. Applicant and facility resident, Manuela Cano Guerrero were caring for a family member’s dog, Bruno. Applicant stated dog will only be at facility until Tuesday, 5/21/24. LPA informed applicant that the purpose for today's inspection is to inspect:
1. Family Room: Two tall wooden shelves were observed to not be anchored to wall in family room (day care room).
2. Pool Gate: End of pool fence by patio door observed to be less than 5 feet. pool gate on step (step is 6 inches tall) making fence 4.5 feet tall.
3. Pool Gate: Pool gate observed to not self-close and not self-latch.
4. Pool Gate: Self latching device observed to be too low, located 13 inches from top of gate.



Page 1 of 2.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Cynthia Sun
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: GUERRERO, LUCY
FACILITY NUMBER: 304314294
VISIT DATE: 05/17/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
A facility personnel summary review shows that all adults in the home have criminal record and child abuse central index clearances or exemptions.

The LPA toured the facility assisted by the applicant. Outdoor play activities will be conducted on the back yard. The backyard is appropriately fenced. LPA observed that applicant made the following corrections:

1.Applicant installed anchors on top of each wooden shelf in day care room. LPA used step latter to take photos and confirm anchors were installed.

2.Applicant installed additional mesh fencing material and reinforcement bars to the end of the pool next to patio door to ensure pool fence is at least 5 feet high around pool. LPA measured and took photos to confirm pool mesh fence is at least 5 feet high.

3. Applicant re-installed pool self-latching piece for gate to swings away from pool, self-close and self-latch.
LPA observed, recorded, and confirmed gate self-closing and self-latching.

4. Applicant re-installed self-latching device to be at required level and making self-latch device no more than 6 inches from the top of the gate. LPA and applicant measured self-latching area and LPA confirmed measurement was approximately 4 ½ inches from the top.

LPA completed Bodies of Water Checklist form used from initial pre-licensing visit 5/2/24.

During today’s visit, the facility met all licensing requirement, and the file will be submitted to the manager for final approval.

In the event additional requirements are needed, the applicant will be notified. A license will be issued once all requirements are met. Appeal rights were provided. Exit interview conducted and report was reviewed with applicants Lucy Guerrero in Spanish.


Page 2 of 2
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Cynthia Sun
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2